REGION – A report from state Attorney General Maura Healey last month highlighted elements of the ongoing debate over a proposed Mass General Brigham (MGB) expansion in Westborough.
Released on Nov. 17, the report takes no explicit position for or against the expansion. Instead, it details information for the state Department of Public Health and the state Health Policy Commission to consider in their review of MGB’s proposal.
“We recommend that HPC and DPH consider this information as part of robust and transparent analyses of MGB’s proposed expansion, including the extent to which these projects contribute to or threaten the state’s goals for cost containment, and their impact on the state’s goals of health care access for all and health equity,” the report says, in part.
Expansion proposal would add clinic in Westborough
Mass General Brigham is looking to open a new ambulatory care clinic in Westborough as part of a larger expansion plan.
Hospital executives have argued that “services are needed and wanted,” saying their proposal would benefit patients and allow doctors to charge lower prices.
“By delivering primary care, behavioral and mental health care, and specialist care along with imaging and day surgery, this ambulatory center will lower costs and increase access to care closer to home,” MGB President John Fernandez wrote in a letter to the Community Advocate earlier this year. “These centers will provide lower-cost options and improve overall health outcomes.”
Opponents of the expansion, however, say it would actually lead to an increase in health care costs while hurting “safety net hospitals” that rely on payments from patients on private insurance plans to offset lower payments from programs like Medicare or Medicaid.
Executives at UMass Memorial Health Care, which operates Marlborough Hospital, have specifically expressed concerns about MGB pulling those private clients to a new facility in Westborough.
Those executives, likewise, have also noted concerns about ongoing labor shortages. Many nurses in particular have been moving into short term and/or out of state jobs, Marlborough Hospital president and CEO Steve Roach said on a call with state and local public officials back in October.
The Attorney General’s report touched on that latter topic.
“Primary care staffing is especially important given the current environment of workforce shortages and the fact that primary care providers often bring their patient panels with them if they move to a new system,” it said.
AG report offers data on expansion plans
MGB, the attorney general said, plans to add 22 new primary care physicians to its system across its three proposed expansion sites.
All this, the report continued, would “contribute direct margins to the MGB system of approximately $385 million per year.”
“Our examination and the projections described above speak to the importance of a broad analysis of the cost impacts of these proposals, including the likely shifts in hospital commercial volume and migration of primary care physicians and specialists from lower- cost systems to MGB,” the attorney general’s office wrote.
MGB has already finalized a payment in lieu of taxes agreement with the town of Westborough, wrapping up negotiations earlier this year.
MGB would send just over $900,000 to Westborough over 20 years under the terms of the deal, which is known as a PILOT agreement.
This was Westborough’s first ever PILOT agreement, town officials said.
It won’t take effect, though, if and until MGB obtains a certificate of occupancy for the property it’s eyeing for its Westborough expansion.
Contacted by the Community Advocate, Mass General Brigham shared its response to Healey’s recent report.
“The Attorney General’s report and its specific focus on Mass General Brigham’s proposed ambulatory sites in Woburn, Westwood and Westborough ignores the health care needs of 227,000 of our current patients who are looking for lower cost health care options, close to where they live from their chosen provider,” the statement said. “At a time when more health care is needed we should focus on providing the care, services, and capacity Massachusetts sorely needs. It is what our patients and the public want and deserve.
UMass Memorial Health also provided a statement following the Attorney General’s report.
“The attorney general’s report is a devastating blow to MGB because it reveals that their true motives are not to serve existing patients, but rather to take commercial market share from local safety net institutions like Marlborough Hospital,” Roach wrote on Nov. 22.
“While that motive is not consistent with MGB’s deceptive multimillion-dollar marketing campaign,” Roach continued, “it is entirely consistent with its statements to investors at the JP Morgan Healthcare Conference, where it described its goals as being to ‘Increase network lives and secondary and tertiary commercial referral volume.’”
“Such drastic commercial expansion of the largest and costliest system in Massachusetts will increase costs for all residents and destabilize safety net providers that care for all community members, including the most vulnerable,” Roach said.
This process remained in its Determination of Need phase as of Dec. 1. That process involves an independent cost analysis, reviewing the impact of MGB’s proposed expansion on local health care costs.
MGB wrote in its statement last week that it expected the analysis would be “formally filed soon.”
“We look forward to continuing to work with policy makers after reviewing that filing,” the statement concluded.